Metyrapone is used for the medical control of hypercortisolism in Cushing's syndrome (ACTH dependent or independent). The aim for medical treatment is to achieve pre-operative control of hypercortisolism, or for control of residual disease persisting post-operatively (TSS, adrenalectomy). It is not for long term definitive treatment/cure, only as an adjunct (surgery is the aim for cure in most causes of Cushing's syndrome). Metyrapone hence acts by inhibiting adrenal steroidogenesis. One side effect is hirsutism (in women) because of the excess androgen precursors created. The other commonly used agent for medical treatment of Cushing's is ketoconazole (an anti-fungal agent). This does not exhibit the side effect of hirsutism.
Important Safety Information for VECTICAL ® (calcitriol) Ointment
Indication: VECTICAL ® Ointment is indicated for the topical treatment of mild to moderate plaque psoriasis in adults 18 years and older. Adverse Events: In controlled clinical studies, the most commonly reported adverse reactions (≥ 3%) were lab test abnormality, urine abnormality, psoriasis, hypercalciuria, pruritus, and skin discomfort. Warnings/Precautions: The maximum weekly dose should not exceed 200 g. Avoid contact with eyes, lips and face. VECTICAL ® Ointment should be used with caution in patients receiving medications known to increase the serum calcium level, such as thiazide diuretics and in patients receiving calcium supplements or high doses of Vitamin D. If aberrations in parameters of calcium metabolism are noted discontinue VECTICAL ® Ointment until these normalize. Avoid excessive exposure of VECTICAL ® Ointment treated areas to either natural or artificial sunlight.
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